NICU nights and cookies!

I'm on NICU and tonight will be my final night before switching back to days. So far it has been an okay month. It started off kind of slow and I was a wee bit bored but then I switched to nights and like all my other rotations on nights I kind of like it. The autonomy, the ability to talk to parents, the quiet, yada, yada.

I'm NOT loving the being woken to a sound of the pager and having approximately one minute to wake up from dead asleep and sprint to delivery to help with baby resuscitation. Jarring and scary and not fun. But otherwise, NICU is okay. Minus the math.

One more month of intern year. It was hard and not that bad and awful and great - depending upon the day, the moment, the month. But I've made it (well almost) I signed my contract for next year so I would have to really mess up now to NOT be a PGY-2 in just 45 short days. Woo hoo!

That is all I've got. Oh and it is national chocolate chip cookie day so I need to go bake. Recipe lifted from some blog way back in my med school days. I tried quite a few and think this one really is closest to the coveted Doubletree cookies. Enjoy!

1/2 cup rolled oats 
 2 1/4 cups all-purpose flour 
 1 1/2 teaspoons baking soda 
 1 teaspoon salt 1/4 teaspoon cinnamon 
 1 cup (2 sticks) butter, softened 
 3/4 cup brown sugar, packed 
 3/4 cup granulated sugar 
 1 1/2 teaspoons vanilla 
 1/2 teaspoon lemon juice 
 2 eggs 
 3 cups semi-sweet chocolate chips 
 1 1/2 cups chopped walnuts 

 1. Preheat oven to 350 degrees. 
 2. Grind oats in a food processor or blender until fine. Combine the ground oats with the flour, baking soda, salt and cinnamon in a medium bowl. 
 3. Cream together the butter, sugars, vanilla, and lemon juice in another medium bowl with an electric mixer. Add the eggs and mix until smooth. 
 4. Stir the dry mixture into the wet mixture and blend well. Add the chocolate chips and nuts to the dough and mix by hand until ingredients are well-incorporated. 
 5. Spoon rounded 1/4-cup portions onto an ungreased cookie sheet. Place the scoops about 2 inches apart. You don't need to press the dough flat. Bake for 16-18 minutes or until cookies are light brown and soft in the middle. Store in a sealed container when cool to keep soft. For the best results, chill the dough overnight in the refrigerator before baking the cookies. Makes 20 cookies.

sick

sick. just plain old cough, sore throat, nasal congestion, headache, sick. NOT sick, sick like some of my kiddos in the hospital. but for sure i got sick from one of those kiddos...

anyhow. just reflecting on my month of wards so far. starting on nights is way different. i like nights for the ability to talk to patients and do things at my own pace. i love the autonomy and the time i get to spend with the med students. i hate being tired and falling asleep while trying to write or dictate notes. i hate the groggy feeling of not caring anymore and just wanting to be home in bed already....

daylight savings night was especially hard. i had rode 60 miles that day for MS150 training so i was physically tired and i hadn't slept much the night before so i was running on only 4 hours of sleep in the past 24 hours going into the night and then because of spring ahead (yay, one less hour to work) i had one less hour to get everything done and we were busy. even my "easy" admit wasn't easy...  her mother only spoke Spanish and there were no Spanish staff to be found, the phone interpreter was hard to hear, the consulting service didn't want to be consulted, etc, etc. all night and morning long.  and then is started feeling sick with a scratchy sore throat and a cough but that was back seat to admits and progress notes to write. and my co-intern had the day off so that meant double the notes for the morning.. and before i knew it,  it was time to round and i had not finished a single note. At  10am when they force me to leave (duty hour violations) i was so tired i was falling asleep on my feet so there was NO way i could do notes then. i came home slept for a few hours and then work up to finish my work.  and when i woke up i was full on sick. but at least i have today to sleep and recoup before tonight.

nights are more than half over, just 3 more to go and then it is on to days and crazy, busy, admit, discharge, work.... but it is my last month of wards as an intern! next time i'm on wards i will be the upper, which is crazy to think about. but i'm feeling more confident and i think i'm ready, or will be. so long as i figure out how to function without sleep.

intern year is going to be over in a flash. just nursery, NICU and behavior and development to go. then i'll be a big, bad 2nd year! wow. time flies.

i'm sick. but happy.  i love my job. and that is all i have on this monday morning.

happy first monday after daylight savings to you!

Awash in Memories

Grenada.
The walk at sunset....

Medical school friends that became friends for life. An Island Away. Quiet spots. An early morning kayak.

Life is good. It is. I like being a resident and I like going to work (most days). I'm back on wards and I started on nights so it I have some free daytime to enjoy life while also getting back in the swing of things. Inpatient medicine is fast paced, stressful, full of admissions, notes and sometimes not the fun stuff. Sick patients, stressed parents, tired staff BUT there is also the nightly rounding, patient and parent interactions that happen and don't feel quite so rushed, autonomy, fun with other tired residents and a quietness that is just not possible during the day. So that is good.

But I've been nostalgic lately. Missing Grenanda. Missing San Diego. Missing the past. Not in an heartbreaking awful way just happy memories and reflections on the joy and simplicity that some of the past held.

That is all I have on this Thursday morning. Headed out to pamper myself with a mani/pedi and haircut. Much needed. And then nap. And then work.

Heart Full

Happy belated Valentine's Day! I know it is just a cheesy Hallmark day and that everyone day should be a day of love... but I still enjoy the day. I always enjoyed exchanging Valentines, and I still do.

Also I'm on an amazing month of ambulatory medicine. All clinics. No weekends. No wards. Days off to work on scholarly projects and study for Step 3. Days off to take step 3. Vacation. A good month. Did I mention weekends, off? I've have a ton of free time and Dr. Boyfriend and I have been making good use of it. We went to NOLA for a long weekend, we've gone to brunch and had late nights and lunch dates. A good month.

Also the medicine is good too. I got to go to Pedi Neuro clinic yesterday morning, swoon.... Loved the attending, interesting patients. And then my continuity clinic in the afternoon, which is always good. So all in all a good day.  A good month.

My heart is full. I like where I am. I love my colleagues and Texas is good for us. I am happy to live with Dr. Boyfriend (finally!) and we love Sancho. I have much to be thankful for. And I am.

I hope you had a good day of love dear reader. Happy February and happy Wednesday!

Why I like working nights.... and shameless plug for the MS 150!

1. It is quiet.
2. I get to work on my own schedule.
3. Minimal BS. Skeleton crew and tired staff meaning people work more efficiently in hopes of getting a chance to nap/rest. But there is plenty of time to hang out too!
4. There is time to hold a baby, or 3 babies like I did last night.
5. There is time to talk to a patient's parents for as long as they want and answer as many questions as they want.
6. It is quiet and calm and you have an autonomy that doesn't exist during the day...
7. You get to backwards commute and parking is never an issue.
8. Breakfast with the hubby.
9. Daytime dog walks and trips to the dog park.
10. You get time off during the day to normal people things like shop or go to the post-office.

That's my short list. I'm just finishing a month of wards and then I go to clinic for the month. Life is good. Intern year in more than half way over and all is well over here.

Donate now and sponsor me to ride one or two of the 166 miles from here to Austin on April 12th and 13th.

Only 72 days until the MS 150! And sponsors that donate by the end of the month will have a chance to win a $25 Starbucks card, so what are you waiting on?!?

Merry Belated Christmas Wishes!

So, I've been sucked into the vortex of residency. But that doesn't mean I'm done with this blog. Life has been busy, but it has also been very good. I worked both the 24th and 25th but it was okay, because someone has to work and because I volunteered my co-interns got the days off to enjoy the holiday. And I enjoyed being at work, I did. Lots of Christmas cheer, Santa sightings and tons of holiday spirit in spite if it all. Being a kid in the hospital is never fun but especially not at Christmas and so yesterday we tried to make the most if it. Silly hats that sing and lighted scarves were just part of the fun.

In other news, I cannot believe that intern year is half over! Hooray! (Gulp.) Wow, how time flies...
I'm actually enjoying nephrology. And next month I'm back on inpatient wards but at our community/county hospital so that will be good. And then I get to take Step 3 in February. And then vacation!!! So very exciting.  So that's what's up with me.

I've decked out our pedi lounge for the holidays and that makes me happy. Belated Merry Christmas wishes to you. And a very happy new New Year too!

P.S. Anyone wear a tacky Christmas sweater on the 24th? I did and it was awesome, not quite as bright as the one pictures above, which I am ordering it now for next year, yay!

Christmas countdown, life and reflections of an intern year almost half over!

Hi all,

I am still here. Sorry if you have been looking for me and I've been MIA. You know, this thing called residency is happening. Doesn't leave too much time for other stuff.

Although my parents did visit Houston for 10 days in October, poor Dr Boyfriend had to do most of the entertaining as I was pulled to MDA (oncology) at the last minute. MDA is suppose to be our hardest month and it was not fun but I survived so I do have that going for me.

Also, Christmas is in 6 days and I am unbelievably excited this year. I have decorated the resident lounge and bought mini stockings for each of us to hang. It makes me very happy. Also (a word I'm using way too much this blog post, sorry about that) I have decided it is okay to wear corny holiday themed antlers and headbands and scarves and hats and all things tacky since I am a pediatrican after all. And I want others to as well so I have declared December 24th, the official wear your tacky Christmas sweater (to work) day! You can participate too, I'd love pictures if you do. If you have to work the holiday you may as well have fun while doing it, that it my motto anyhow.


I'm up early this morning. Presents are wrapped. Cookies are baked. I do have some clinic notes to complete though..... but blogging is more fun.

Oh and random links, just because:

1. interesting, my future research is going to do with this i think:
EverythingHealth: The Microbiome

2. fun gift ideas for the last minute hard to shop for person on your list: http://gifts.rescue.org

3. just because: http://www.pinterest.com/pin/72057662761780782/

Merry Christmas!!!!

P.S. Don't forget- tacky sweater on 12/24. And the best way to spread Christmas cheer? Singing loud for all to hear!

mimosa, samosa... life after wards

Wards is over, I made it! There were many times in the past month that I doubted my desire to do this. To be a doctor. To complete residency. Multiple days/nights when I just did not want to go to work.... But yesterday at 10am when I walked out of the hospital I felt accomplished. And my spirits climbed as I brunched and shared multiple pitchers of mimosas and good company.

My collapse into bed followed by wonderful sleep before meeting my awesome wards team for outdoor theatre fun in the form of Bollywood dance made yesterday the perfect ending. I had a good day, a good month. I am now that much more confident that I can do this job. And more importantly that I still want to.

Nights were difficult for me. I feel into a semi depression and despite the actual free time I only slept and worked. It is only now as the nights and memories of them recede that I feel myself again. The reading, the to do list, that didn't happen... but it is okay, because I survived and came out the other side and I'm still here. And now I have energy and optimism once again.

A sampling of what I saw last night, I just LOVE Indian culture/dance/food!

Night after day after night...

Residency day 57.

Well actually night 2, as I am officially on nights. We have kind of an odd system when on wards where you work every other night for two weeks. Saturday was my first "night" and it was rough because I haven't had to stay awake for 30 hours straight in a very long time. I was falling asleep while writing up my H&Ps and that was an awful feeling. I will be prepared tonight with gum, candy and an extra cup of coffee for 3am. The every other night off is kind of odd. 16 hours on. 30 hours off. In theory that sounds nice but it hard to get on a schedule. I had planned to simply sleep all day and then use my off night to read, do things around the house, etc but I guess that residency caught up with me because I simply slept for 18 out of the last 24 hours. Ooops. Now I have all day "off" before I got to work tonight and it is not the weekend and so Dr Boyfriend is at work and I have the house to myself. So what to do...  Finally, I can read! I am so behind in everything, it will be nice to read about medicine and not medicine. I need to go join the Houston Public Library. And grocery shop and bake and lounge and do laundry. And exercise. And finish my graduation thank you notes. Yes, residency  has kept me busy. My to do list is long. So I'm thankful for the time right now to catch up.

Otherwise I really don't have much to say. Inpatient wards is busy, good, horrible, awful, scary and/or fun depending upon the moment in time. I hated my first week and rather enjoyed my second week. I like the patient care aspect of it and struggled with the documentation aspect. There is never time to write good thorough notes and yet I know that notes are super important and without good documentation it is difficult to practice good medicine. And yet I struggled with this daily.  I can only hope I get more efficient as time goes on. I am trying to dictate but that has pitfalls too. Being an intern is about doing paperwork, calling the consults, updating the lists and admitting/discharging patients. I ended up staying  late to talk to parents, answer questions, etc because there really just isn't time during the day for that aspect and it is the education part of doctoring that I so love.

Time to work on my to do list, and maybe walk my dog. Happy Monday to you!

Residency, day 48... feels like 539

I am now about to start my eighth week of residency, crazy huh?

I finally get today off after 12 days on and it is a glorious feeling to have an entire day to myself without  a pager or need to set foot in the hospital! (Minus those delinquent discharge summaries to finish.) Thursday was maybe the second hardest day of residency.... more lows, more tears, a migraine, a screaming child, not enough hours in the day to take care of everyone and myself. But then it was Friday and I had one of the best days of residency. I utilized my medical students and I took the time to pre-round with them. We were efficient on rounds and I made it to noon conference with a hot lunch in hand. I made decisions by myself. I admitted two patients, discharged three, supervised my med student talking out his first PICC line and almost made it out in time with only an hour worth of notes to finish when I got home. I survived my first week and half of inpatient wards and I see the light... five more days on and then I switch to nights for the rest of the month. So all in all, I'm okay.

More than okay. I'm surviving despite what I felt like was going to be the worst month of my life. Some days have been quite craptacular. I feel like a glorified secretary. I haven't been reading like I know I should. My sick patients scare me. I think the medical students know more than I do. I feel slow and have yet to finish my progress notes before rounds or even before lunch time.  I am not good at multi-tasking. I am an intern. But I notice that I'm faster than I was a week ago and more confident each day than the day before. I am figuring out the little things and those make a big difference.

Residency is hard. I'm awake at 5am on my single day off in two weeks. I could complain about many things. But I also realize that I'm lucky. I'm doing what I have always wanted to do and the little things add up. The educating patients and supervising med students and being responsible for my own time.

I'm happy. Exhausted. But happy. Enjoy your Saturday, I know I will enjoy mine!

Golden Weekends

In residency having two days off in a row is kind of a big deal. So much so that it has its own name. golden weekend.



And since residency has started this is my first golden weekend. Although working 12 days straight kind of sucks I think I'd rather do that once if it means I get a golden weekend in return. There is something magical and restorative about having two days off in a row. Yesterday I cleaned, exercised, hung out with hubby and my Sancho, slept in, met co-residents for a drink, furniture shopped and watched a movie. It was a pretty great day off and now I still have today to read, study, BBQ w/friends, swim, grocery shop and finish laundry. By Monday I'll be ready to work which is good because I start inpatient floor this week. just three more days of ID left. I think I'm ready, ID was a great intro but it will be nice to be the primary provider and not simply a consultant...

I've survived my first month of residency, I adore my co-residents and I don't imagine I'll ever grow tired of newborn babies or toddling kiddos or sultry teenagers, peds is awesome and I'm reflecting on just how blessed I am this early golden weekend Sunday.

Happy weekend to you!

Internship, day 9

So.
It happened.

Intern year started and I survived my first week. I won't lie. It was rough. I felt like a glorified medical student at my best and a worthless imposter in a long white coat at my worst but I made it through. I finally figured out how to get from the elevator to the lounge to the PICU to the bathroom to conference without getting (too) lost. I started to create my own templates and navigate myself around several different EMRs. Now that I'm one plus week in I'm starting to actually feel semi-confident. Or at least no longer super stressed that I'm the worst resident in the world. It is a gradual process.

Of course that being said, I only have one more day of work and then I'm on vacation to The Best Place on Earth. I figured it was a long shot to ask for vacation two weeks after starting but someone has to take vacay in July so why not me? I'm glad I'm going. MS Teen Adventure Camp is the reason I decided to go into Child Neuro so to NOT go to camp would be like a fish that decided to go without water for a minute. I might survive but it would not be pretty.

Residency is scary and I'm not even on the wards yet. I'm on ID this month so it is just consults with tons of fellow and attending support. But still, I'm Dr. Neuro Chick-Kid Doc when I walk into the room. And it is absolutely amazing. I love my patients and parents, I love my job and I especially love the fact that I get to do this for the rest of my life. Today was orientation to continuity clinic and I already have patients scheduled to see ME. I browsed their charts and I just can't wait to see my 5 year old and my brand new newborn baby and the reluctant teenager and whoever else may walk in the door. I just can't wait!

Internship day 10... bring it!